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May 9, 2017

How Real-Time Notifications Help ERs Fight The Opioid Crisis

The dramatic rise in opioid use in the United States has forced emergency rooms to the front lines in our nation’s fight against drug addiction. ER doctors and nurses are now in a daily struggle in the choice between appropriately alleviating a patient’s pain and possibly feeding an established or growing dependency.

Like many caregivers across the spectrum of our healthcare delivery system, these emergency medical teams need greater support in the diagnostic decision-making process.

Overall, grasping of the scale of the opioid crisis is difficult, but estimates put the number of persons addicted to prescription opioids at more than two million and rising rapidly. Deaths from prescription opioid overdoses have quadrupled in recent years, totaling more than 165,000 between 1999 and 2014. Further, a recent report from the CDC suggests that the average of 91 daily overdose deaths may be underestimated because other health issues made worse from the addiction had been listed as the cause of death.

The pressure on ERs is staggering. For staff, helping drug-seeking patients is a very difficult, and often disproportionally time-consuming portion of their daily responsibilities.  A report earlier this decade estimated that approximately 20% of all emergency room traffic is from persons with drug-seeking behavior (DSB). Additionally, a study of the drug-seeking patients found that they visited ERs on average 14.5 times per year—far more than the control group average of 2.1 visits per year.

While there is no single solution to the opioid crisis, there are states taking positive steps to turn the tide. In New York, all prescriptions for narcotic painkillers must be transmitted to a pharmacy digitally, and then verified during an additional step. And in Massachusetts, prescriptions for post-operative, first-time narcotic painkillers are limited to a one-week supply.

Another key is improving the connectivity and communications between caregivers. This is especially true as drug-seeking patients engage in what’s known as “hospital shopping,” or bouncing between ERs to find doctors who will prescribe them more opioids.

A new feature from the PatientPing platform addresses this problem directly by flagging high utilizers and alerting a patient’s provider when they’ve registered at an ER.

For providers monitoring their high-utilizing patients, this tool offers an opportunity to appropriately intervene and engage with the ER team in real time to collaborate on the most appropriate care. This straightforward approach facilitates better care coordination and enhances support for healthcare decision-makers in ERs.

For the patients, it puts their PCP at their side as an advocate and as a guide to ensure that there are no detours on their individual care path. And if the patient is specifically seeking opioids, the PCP and ER team will not only have a fuller picture of their addiction history but also a stronger web of support for accessing community resources.

ACO Care Coordination Best Practices

Tagged: Care Coordination, high-utilizer, high-risk patients, opioid epidemic

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